8.30 POSSIBILITIES FOR THE DEVELOPMENT OF LEFT VENTRICULAR DIASTOLIC DYSFUNCTION IN PATIENTS WITH TYPE 1 DIABETES MELLITUS

Abstract

Left ventricular diastolic dysfunction (LVDD) is one of the early manifestations of diabetic cardiomyopathy, which is common in patients with type 1 diabetes mellitus (T1DM). Predicting the development of LVDD in such patients is important for early diagnosis and timely intervention, which can slow disease progression and improve outcomes.

Key Words: Left ventricular diastolic dysfunction, diabetes mellitus, insulin

Purpose of the studyis to identify risk factors for impaired left ventricular diastolic function in patients with type 1 diabetes mellitus (T1DM) and assess their diagnostic and prognostic significance to create a model for predicting the development of diabetic cardiomyopathy.

Material and methods: The study is based on the results of a comprehensive examination of patients with T1DM, the disease duration of more than 5 years, who received treatment in the endocrinology department of the City Endocrinology Hospital of Samarkand and were on an outpatient basis in the period from 2020 to 2023.

The study sample consisted of 140 patients with T1DM (72 men and 68 women). All patients received basal-bolus insulin therapy, including long-acting and ultra-short-acting human insulin analogues; In 5 patients, insulin pump therapy was used.

Exclusion criteria from the study included the presence of T2DM, other specific forms of diabetes, the presence of diabetic macrovascular complications, diabetic retinopathy in the preproliferative and proliferative stages, as well as a decrease in glomerular filtration rate ≤45 ml/min, a history of cardiac arrhythmias, arterial hypertension, polyneuropathy of non-diabetic origin , alcoholism, chronic alcohol intoxication, pregnancy, lactation and concomitant endocrine diseases (pathology of the thyroid gland, adrenal glands, etc.). All patients included in the study were diagnosed with diabetic cardiomyopathy according to the “Algorithms for providing specialized medical care to patients with diabetes mellitus.” The diagnostic criteria for diabetic cardiomyopathy is the presence of two or more abnormal findings. All patients with type 1 diabetes were assessed for left ventricular diastolic function using echocardiography, in accordance with OS recommendations [14]. To characterize left ventricular diastolic dysfunction, the following signs were used: ratio E/e' average >14, velocity of the medial part of the mitral valve annulus e' <7 cm/sec, left atrial volume index >34 ml/m². If 3 of these signs were detected, left ventricular diastolic dysfunction was established.